Frequently Asked Questions

Q: How long has fractional exhaled nitric oxide (FeNO) testing been available?

Measuring FeNO in patients with asthma has been investigated since the early 1990s. Aerocrine, now NIOX Group PLC, was created by pioneers in FeNO research and launched the first commercially available FeNO-measuring device over 20 years ago.¹ Today, NIOX® remains committed and dedicated to FeNO instrumentation. Over 45 million FeNO tests have been performed worldwide using a NIOX® device.²

Q: Should I replace spirometry with FeNO?

FeNO is not a replacement for spirometry. FeNO measures nitric oxide in exhaled breath (which is increased in the majority of airway inflammation associated with asthma), while spirometry measures airflow limitation or obstruction. Both provide important information about different aspects of airway disease, such as asthma. For example, FeNO can provide information on the level of underlying airway inflammation, but it cannot tell you the degree of airflow obstruction. However, for treatment optimization, numerous studies in both children and adults indicate that adjusting inhaled corticosteroid (ICS) doses according to FeNO values gives reductions in asthma exacerbations of up to 50%, in patients at risk for future events as compared to traditional monitoring.^3-5 Therefore, measuring FeNO in addition to spirometry is advised.^3-8

Q: Is FeNO testing suitable for children?

NIOX VERO® is suitable for children, 7-17 years, and adults 18 years and older. NIOX VERO can be operated in two exhalation modes, 10 seconds or 6 seconds. The 10-second test mode is for age 7 and up, and the 6-second test mode is for ages 7-10 only when a 10-second test is not successful. NIOX VERO cannot be used with infants or by children under the age of 7 years, as measurement requires patient cooperation. FeNO can be measured in children aged 7 years and older with high success rates after coaching them through the procedure. FeNO can play an important role in the diagnosis and management of their disease.^9,10 In several studies, asthma therapy directed by FeNO has been shown to reduce asthma exacerbations in children at risk for future events when compared with symptom-based care or usual care.^3,5,13,14

Q: What factors besides asthma can affect FeNO measurements?

Other known causes may alter FeNO values. Significant allergic or respiratory disease or respiratory viral infections may affect FeNO.15 A diet rich in nitrate-containing foods may raise FeNO^15-17 while smoking may reduce FeNO.^11,18,19 Certain medications, particularly corticosteroids, can decrease FeNO.^11,15 For additional information, please see the NIOX VERO User Manual, Section 9.3, Substances disturbing FeNO measurement.

Q: How do I calibrate my NIOX VERO device?

The NIOX VERO instrument does not require calibration. Sensors are calibrated directly against chemiluminescence methods during manufacturing and do not require re-calibration by the user.

Q: How often does my NIOX VERO instrument need to be serviced?

No servicing of the NIOX VERO device is required, minimizing any disruptions in testing during the operational lifetime of the device. Sensors are calibrated directly against chemiluminescence methods during manufacturing and do not require re-calibration by the user.

Q: Why does my NIOX VERO instrument expire?

Like other instruments, NIOX VERO has internal components that become depleted with use and will not last indefinitely. The operational lifetime of the instrument is a maximum of 5 years in use or 15,000 measurements or the expiration date, whichever comes first. The sensor has an operational lifetime of 12 months after installation or the expiration date (whichever comes first) and the breathing handle can be used for 1000 measurements or one year (whichever comes first).²⁰ Aging and stability testing have confirmed that the instrument and components will provide accurate results throughout their stated shelf-lives and a robust Quality Assurance program is in place to ensure that the instrument and its components will consistently function over their operational lifespans. Note that any instrument that is purchased will have a lifespan of 5 years or 15,000 measurements, whichever comes first.

Q: How do I know when my NIOX VERO instrument will expire?

By accessing the instrument settings, the number of measurements remaining and the expiration dates of the NOIX VERO device and sensor can be verified. For step-by-step instructions, please see the NIOX VERO User Manual, Section 5.6.5, View instrument information. Also, alerts will display on the screen to inform the user of upcoming and past expiration dates for the instrument, sensor and breathing handle.²⁰

Q: How do I dispose of used and/or expired NIOX VERO instruments, sensors and breathing handles?

Do not heat or dispose of the NIOX VERO instrument or sensor in fire.

• Used or expired NIOX VERO instruments and breathing handles should be disposed of as hazardous waste in accordance with local waste disposal regulations.
• Used or expired sensors should be recycled according to the local recycling program for electronic equipment.
• Used batteries should be recycled according to the local recycling program for rechargeable batteries.
• Used patient filters should be disposed of as biohazard waste.²⁰